Why did I receive a bill from RIA, Radiology Imaging Associates (or Quest or Labcorp) for services my insurance should have covered?
Often, the third party does not have our patient’s insurance information correct, or they do not have the patients’ secondary insurance on file. Our Patient Financial Counselor, Jaimi Bogart can usually call the third-party service provider on the patient’s behalf to correct or add the information. At that point, your insurance company can be billed correctly for the services you received.
I just received a bill for healthcare services I received in 2019- why are you just now billing?
It is no secret that our billing processes have been bad the last several years. Despite our best efforts, we have not made progress the way we’d like, or the community deserves. For that we are deeply sorry. As we work to improve, we have terminated our relationship with our past partners and are starting a new relationship with a new company. TruBridge is a recognized leader in supporting rural hospitals with their billing processes. They will assist our internal Medical Billing Team to ensure expediency and accuracy on your healthcare bills moving forward. In the circumstance when an invoice becomes past due, Trubridge staff may also contact patients to process self-pay payments for your portion of the financial responsibility. You will soon be receiving a statement from Trubridge, as they will be rolling out the first round of bills on Lincoln Health’s behalf in June. Lincoln Health staff has reviewed every account for accuracy before releasing these statements.
I received an Explanation of Benefits (EOB) from my insurance company quoting an amount I am responsible for but my invoice from Lincoln Health does not show the same amount. Why?
This is usually an internal posting error. These types of errors should be reduced now that we are working with TruBridge, a recognized leader in supporting rural hospitals with their billing processes. If you should experience such an issue, please contact Jaimi Bogart, Lincoln Health Patient Financial Counselor.
My insurance is not paying my medical bills because Lincoln Health/LCH is not in the network.
We have contractual agreements, making us In-Network with most major insurance companies, and are diligently working to establish agreements with new insurance companies, like Bright Health, all the time. If you don’t know if Lincoln Health is In-Network for your insurance provider, please contact us- if we’re not, we may be able to establish an agreement.
We are dedicated to the continued improvement, accuracy, and ease of the billing process for our patients. Ensuring you receive a complete, timely, and most importantly easily understandable bill for the healthcare services you receive at Lincoln Health is our ultimate goal.
Frequently Asked Billing Questions
If you have specific questions about your billing statement from Lincoln Health, please contact our Patient Financial Counselor, Jaimi Bogart.
Jaimi can be reached by phone at (719)-743-2294 or by email at firstname.lastname@example.org.
Patient Financial Counselor
Business Office Director
What is a provider based physician practice?
A physician practice (Gordon Clinic, Flagler Clinic, Limon Family Practice) that the Hospital (Lincoln Community Hospital) operates, maintains and supports as an outpatient department of the Hospital.
What are administrative and facility costs known as “facility fees”?
They are costs incurred by the Hospital in operating the practice, (i.e. overhead costs such as electricity, phones, heating, cooling, etc., equipment/supplies, and compensation for non- professional staff. These costs are necessary for Lincoln Community Hospital’s Physician Practices to see and treat its patients.
Why are you charging me twice for the same day?
This clinic is a provider-based practice and based on Medicare guidelines, there is split billing for the professional fee and the facility fee. The Hospital incurs significant cost in operating and maintaining the clinic, and the facility charge helps to cover that cost. The professional fee is for the physician or ancillary provider service. These charges are equal to the amount that would have been billed as a single charge prior to the conversion to a provider-based clinic. These guidelines went into effect in 2001.
I did not go to the hospital; I went to see my doctor…
The Physician Practice clinic location where you were treated is an outpatient department of Lincoln Community Hospital. The Hospital is responsible for the cost to operate and maintain the clinic; therefore, based on Medicare regulations, it is an extension of the Hospital.
If my insurance company is not paying for the charges, why should I?
We are required to bill you for balances not paid by your insurance company. Your claims were processed based on your benefits for outpatient hospital services and you are responsible for any balance not paid.
What if I don’t have Medicare?
Many private insurers recognize and value the integrated care provided to their insured members in provider-based facilities. Such insurers generally follow Medicare’s guidelines in processing provider-based claims. However, claims will be billed depending on the requirements of your insurance policy.
Does this mean patient’s will pay more for services?
Depending on their insurance coverage, it is possible patients may pay more for certain outpatient services and procedures at our provider-based/hospital outpatient locations than at other standalone sites. We recommend patients review their insurance benefits or contact their insurance provider to determine what their policy will pay and what out-of-pocket expenses they may incur.
Why wouldn’t I just go to another to another clinic then where they won’t bill me a facility fee?
We are sorry that you feel this way and understand your frustration with these new billing practices. The laws governing this type of billing structure went in to effect in 2001 and our facility just recently started billing via this method starting in May of 2017. Part of this decision was in response to the higher costs of providing care. We are willing to work with you on your bill and offer a variety of payment options and even discounts, when applicable.
Where can patients call with their questions or concerns?
Patients may contact:
Our Patient Financial Counselor; Jaimi Bogart at Jbogart@lchnh.com or 719-743-2294
What can patients do if they are having difficulty paying for healthcare services?
Lincoln Community Hospital offers various payment options. For further details please contact our Patient Financial Counselor at the number listed above.